[Treatment of severe head injuries by external ventricular drainage and barbiturate therapy. Mortality and morbidity in 57 cases (author's transl)].
After severe head injury the majority of deaths, during the early period, is due to acute intracranial hypertension. We report a series of 57 severe head injuries with early signs of brainstem involvement. CT Scan performed within 6 hours after injury and repeated at 48 hours showed hemispheric lesions and edema, without shift of the middle line. Treatment consisted of controlled ventilation, water and sodium restriction and barbiturates. A ventricular catheter was inserted in 52 patients allowing intracranial pressure (I.C.P.) monitoring, and permanent subtraction of cerebrospinal fluid (C.S.F.). This treatment allowed the control of a normal I.C.P. in 80% of the patients. In 6 patients a secondary surgical treatment was performed. In this series the mortality rate was 31,5% the good results and moderate disability 54,3%, the severe disability and vegetatives states 14,2%.
D000293:Adolescent; D000328:Adult; D001463:Barbiturates / Q000494:pharmacology / Q000627:therapeutic use*; D001930:Brain Injuries / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002557:Cerebrospinal Fluid Shunts; D002998:Clonazepam / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects*; D008297:Male; D008353:Mannitol / Q000627:therapeutic use; D008875:Middle Aged; D012121:Respiration, Artificial; D014057:Tomography, X-Ray Computed
D001463:Barbiturates; D008353:Mannitol; D002998:Clonazepam; D003907:Dexamethasone
Traumatismes cranio-cérébraux avec signes précoces de souffrance axiale. Traitement par drainage ventriculaire externe et barbituriques. Mortalité et morbidité d'une série de 57 cas.